Constipation is mainly caused by the disturbed transmitting function of the large intestine and also related to the function of the spleen, stomach and kidney.
In view of the difference in etiology and pathogenesis, this illness can be divided into two types: deficiency and excess.
Etiology and Pathogenesis — After food is digested by the spleen and stomach its refined nutrients are assimilated and the wastes are egested through the transmission of the large intestine. If the stomach and intestine are diseased, various kinds of constipation occur in the following condition, inter-accumulation of dryness and heat, stagnation of qi, deficiency of qi with inability of transmission, blood deficiency with dryness of the intestines and agglomeration of cold. Constitutional yang preponderance, or indulgence in alcohol and spicy, greasy food may lead to accumulation of heat in the stomach and intestines or after some fevrile disease, the remnant heat and insufficiency of body fluids give rise to dryness and heat in the intestines and in addition, there may be disturbance of fluid distribution to the lower jiao.
Constipation is present in any of the above cases. Emotional factors, such as anxiety and depression, or lack of movement can cause stagnation of qi, impairing the transmitting function of the large intestine. As a result, the wastes are retained inside and unable to move downward and hence constipation.
The coexistent deficiency of qi and blood can result from internal injury by overstrain or improper food intake, or happen after an illness or delivery or in the aged people. Qi deficiency results in weakness of the large intestine in transmission, while blood deficiency gives rise to shortage of body fluid, then the large intestine can no longer be moistened.
Apparently both qi and blood deficiency can cause difficult evacuation of the feces and hence constipation.
Constitutional debility or senile decay results in the retention of endogenous cold in the stomach and intestines. Consequently the yang qi is obstructed and the body fluids fail in distribution. Difficult of the large intestine in transmission leads to constipation. Constipation whether deficiency or excess can be treated with acupuncture and herbs.
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